Sebelius: 'Speed up the rate of change'

Policy leaders look to transform healthcare
By Mary Mosquera
09:58 AM
Kathleen Sebelius

Leaders of healthcare policy encouraged the industry to speed up the rate of change during a keynote address at the National Health Policy Conference Monday in Washington, D.C. “… help us speed up the rate of change,” Health and Human Services Secretary Kathleen Sebelius encouraged conference attendees.

“If you are already in the vanguard of transforming care, now is the time to take the next step forward. If you’ve been considering participating in a new care model, now is the time to take the plunge. If you’ve been waiting on the sidelines to see how this was going to shake out, now is the time to get in the game,” she said.

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Many elements of change are happening at the same time and they need to be synchronized, Sebelius said. For example, new models of care in the healthcare delivery system. More than 250 organizations of a variety of shapes and sizes have agreed to form accountable care organizations (ACOs), and 4 million Medicare beneficiaries are receiving care from them, she said.

In response to payment changes and incentives, providers are embracing data tools to improve care and share information between provider and patients. The use of basic electronic health records (EHRs) has doubled since 2008 and more than 80 percent of hospitals have committed to being meaningful users of EHRs by 2015.

“Most importantly, the changes are translating into improvements in patients’ lives,” she said. For example, hospital readmissions in Medicare have fallen nationally, up to 25 percent in some areas.

But providers cannot retain the same delivery system models from a fee-for-service world, according to Farzad Mostashari, MD, the national health IT coordinator. “Meaningful use was meant to prepare the ground for the new models of payment,” he said at the conference.

Meaningful use provides the transition for preparing the infrastructure for new models of paying for and delivering care. In meaningful use Stage 2, health IT systems need to talk with each other, which is a challenge around technology to agree on standards and specification. But if it isn’t in the business interests of a hospital, information will not flow, he said. 

“Whether the new models are ACOs, patient-centered medical home, or value-based purchasing, the direction now is you have to coordinate care better, whether it’s Medicare, Medicaid or private health care,” he said.

That kind of coordination doesn’t happen overnight, added Paul Tang, MD, chief innovation and technology officer at Palo Alto Medical Foundation, but it can be done and there’s a strong business case for doing so.

Under the Affordable Care Act and new payment models, he said after the keynote, businesses “get the savings” from care coordination. “In the fee-for-service world,” he noted, “it’s not a good deal.”